The Exact Checklist to Launch Your Physical Therapy Cash Practice | CashPT Lunch Hour #108

Foreign. Hey, what's up? It's Aaron Labourer and welcome back to the Cash PT Lunch Hour podcast. I'm your host and today's episode is just for me. And I'm going to show you what you need to know to get all set up and running a profitable cash based physical therapy practice. So if you're just getting started, today's episode is just for you. If you've already started, let's say you started six months or even six years from now or six years ago, today's episode is going to have some great tips and tricks and some ninja strategies for you. So listen in because even if you've already started, there sure to be a few things that I'm going to mention today that either you didn't do initially, which would be a good idea to work on right now, or you just need to hear some of these things multiple times. So what I'm going to do is share with you the checklist and what I created when I started my practice. And it's called the Cash PT Checklist. This is a checklist that contains all the essential steps to starting a cash based physical therapy practice. If you want to right now and pause the episode, you can go to cashptchecklist.com you can pause the episode, go there, download the checklist right now for free and follow along with us as you go through this or at the end of the episode I'll mention the URL again where you can go get your free Cash PD checklist so you can have it at home, you can download it, you can print it out and have it in your hands. Like I've got one in my hand right now and I'm going to go through it with you. So when I started my practice, I was trying to organize my thoughts and what do I need to get done. So I started organizing them, you know, boom, boom, boom. And then a few years later when people started asking me, Aaron, how'd you build a cash practice? How do you get people to pay you hundreds of dollars to come see you for physical therapy? And I started helping people and coaching and consulting. And one of the most valuable things that I had were the documents that I use to build my practice, like the Cash PD checklist. Everything that's in the Cash PD toolkit. And I use those things to, you know, basically say, hey, here's how you do it, here's your organization, here's what you need so you don't forget something in the process. Because when you're getting started, you'll get to a point where five things need to happen all at once. So in order to get an EIN number, you have to have an llc. And in order to have an llc, you have a bank account. In order to have a bank account, you got to have some kind of address. In order to get your insurance, you got to pay for all these things and you got to do these things, and it's boom. So I created the Cash PT checklist just to make sure you get everything done right. So there's four, there's one, two, three, there's three main parts to the checklist. There's setting up your business. There's a location and operations, and then there's marketing. You guys, we actually need to do marketing. But before we can really market, we got to get some things set up. So to set up your business, think about this. Think about how do I get my business up and running with the least amount of friction possible so I can treat patients? Okay, so what do I need to do minimally to treat a patient? Well, the minimum thing you need to be able to do is you need to be licensed in your state. You need to have liability insurance, you need to maybe have some kind of local license or state license to practice physical therapy as a business. This isn't your state licensure, but this is more of like your business license type of thing. So in North Carolina, it's not a city license to do the business, it's a state license, insurance license to practice your business license, business. And. And a business entity of some sort. You can always start as a sole proprietorship and move that into an llc. If you start, you don't need to allow the LLC to delay your business. You can file a sole proprietorship and just see patients. And you need a way to collect payments. So business setup. You need to have a state license to practice physical therapy. Enough said. You need a city or state business license. So in North Carolina, that's called the Art of healing license. In your state, it might be something else you want to. You need to really have or choose a business entity status. So whether that's llc, PLLC S Corp, or even sole proprietorship, the options are specified by your local state government. So in some states like North Carolina, we cannot form a PLLC as a physical therapist. It's written in the law and which professions can. And physical therapist isn't one of them. We were trying to get it changed, but it's not top priority. I think in places like in California. In California, you can only be a PLLC well, that's not exactly true if you have the right lawyers. But the difference is a PLLC is a professional limited liability corporation. And what that means is only people of the same profession can be owners of the business. Say accountants, for example. If all the accountants who are partners are owners, the only owners can be the accountants. Like the spouse who's not an accountant can't be an owner of a pllc. So if you want to form a multidisciplinary practice and have multiple owners, PLLC is not necessarily in your best interest. And I need you to know that the difference between having an LLC as your entity and filing your taxes as an S corp like they can both happen at the same time. You don't have to be an S Corp to file taxes as an S Corp. You elect to file your taxes as an S Corp and that changes your status. One's a tax filing and one's like a legal filing. Does that make sense? Probably not. That's where you need to consult a lawyer who's licensed in your state and does business. And you don't need to pay thousands of dollars for this. Just check in with your accountant, check in with a lawyer, find out what they recommend and do it. Okay. You need a business name or a doing business as. So in order to get an llc, you need to have a business name. Don't let deciding on your business name take three months and you not move forward. You can always start as ABC Physical Therapy llc. And and if you want to come up with a creative name later on, you file a DBA of creative name Physical Therapy and then you can rebrand your business that way. You need liability insurance, individual and general liability. Slip and fall for your physical location. Or if you're mobile, you need liability insurance that covers you wherever you are. Providing physical therapy. One of the resources that we use in our practice or what we do and what I recommend for a lot of my coaching clients is American Professional Agency. I believe they started by insuring psychotherapists, but now they insure occupational therapists, physical therapists, etc. And what you need is not just the insurance that covers you working for someone else. You need the insurance that covers you as the owner of the business. American Professional Agency doesn't underwrite in all 50 states. In most states they do. I think maybe they don't in Florida, but there's other ones. Just get one and move forward with it. It's very similar to hpso. It was a little bit less expensive than hpso, but if HPSO is the only option. Choose it, do it, get it done, and then maybe next year you can shop around. The whole idea is the faster you make decisions and faster you take action, the sooner you will get to success and have some cash flow. So you can really grow your business and start, start helping patients. And you may also need, if you have a physical location, permits for signage, if you're going to have sign or building inspection or some other things like that. So check with your local and city ordinances, if there's anything specific you need, if you're building out a space or coming into a new space, etc. Okay, so location operations, some of the things you need for day to day operations in your business, you're going to want a payment policy and you're going to want a cancellation and no show policy. And you're going to want to make sure your patients know about these things before they come in for their first visit and at their first visit. And you're probably going to want to find a way to deliver them online or through a secure portal. Right now we use our online EMR system, we're using Indateq for that. And you need to enforce your no show policy. It needs to be clear. We've had a lawyer draw up our payment policy. I've put together my no show and cancellation policy. And she was like, yeah, those look great, they're fine. We just have to enforce it. And our no show policy is basically, we tell people when they schedule, we tell people the forms and when they show up. And then if they miss the first one, whether it's their fault or our fault, you know, someone else's fault, it's not if it's our fault, but if it's their fault or no one's fault, you know, force of nature, we usually forgive the first one and we will say, Mrs. Jones, we totally understand. Life happens. Look, the first one's on us, but here's our policy. And why? Because we want to be able to get other people in. And if we don't find out, you know, outside of 24 hours, we don't have time to get other people in. And so the next one's on us. You know, so the first one's on us, the next one's on you. Does that make sense? So a big piece of this policy is just transparency, being fair. And don't be afraid to charge people. So let me just clarify. I was like, the first one's on us. And the second, you know, here's our policy. The next time we're going to charge you. Fair enough. Fair enough. Okay, so you need a rental or sublease agreement. Like if you're renting or subleasing, you're going to need an agreement and you don't want to just accept the agreement that the landlord gives you and sign it. You're going to want to have someone who is familiar with commercial real estate or real estate law, or even the lawyer that set up your business. Just have a look at it and make sure it's also in your best interest as well. If you don't have a physical location, like let's say you're a mobile practice or you have a couple different gyms where you're working out of, you need to have some kind of mailing address. My suggestion would be use a PO box rather than your home address. But that's not necessarily where people are going to come to. But, but you just want to have an official mailing address. This does two things. One, it keeps your physical home location somewhat secure. Two, when you wake up in the morning and you go to the post office to check your mail, the trip from home to the post office isn't deductible. But the trip from the post office to your next patient to the gym, to the next patient to the gym and then back to the post office, everything in between there is a deduction. So you check the post office first thing in the morning, last thing at the end of the day. So only while you're at work and driving and then when you go home, your trip home and your trip to work. Those aren't deductible on your taxes, but everything in between is. You need a telephone number and you need to get the service installed if you have a physical location. If you're mobile, great. Just don't give out your personal cell phone number. Get a Google voice number or get a local business number, but you don't have it located in a landline. It's just auto forwards to your cell phone until you grow and scale enough and then you can have it forwarded to someone else or a physical location. You're going to need to set up time to get the Internet service installed. You want a business checking and maybe a business savings account, but let's start with at least just a checking account. And you might need to order checks and those might take a few weeks, but these days do you really need to order checks? Not a lot of people pay the checks, but you want to get the bill pay set up. And remember, it takes time and you're going to need to walk into the bank with some kind of business information. You know, llc. If you need a business banking account, you're going to need your articles of incorporation. And don't let that keep you from starting because you could use your personal account right now while you're getting started. Because a good accountant will see expenses are expenses. And even though you might be starting a llc, you're still your business at this point, so it doesn't really matter. Just keep track of all your business expenses, keep track of all your business income and a good accountant will separate the two so that you're not. You don't have any undue tax liability. You're going to want to have some kind of computer, tablet or smartphone to run your business for note taking, scheduling, etc. We use a lot of Google services, so G Suite for business is a great one. It's only like $12 a month and it's HIPAA compliant. We do all our documentation, scheduling, etc. Through there credit card processing. Right now we use GoCard Connect and it's great. It's actually less expensive than Square and it allows us to do card on file transactions to set up payment plans where people are automatically. The money's automatically charged to them rather than automatically sending them invoices. And then you need a documentation system. So we use G Suite as our online emr. We also I've created a digital download, it's called the cache PT toolkit where it's got over 30 or 35 files in it that we use for documentation and marketing and running our business. And a lot of those are online or we used to actually print them out. So if you're in a stage where you just need to print something out for a little while until you figure out some of these other pieces, that's a great resource. So by the way, when you download the CashPT checklist at cashptchecklist.com you will get links to all these resources so you don't have to go searching for them. So go to cashptchecklist.com and download it and there's all the links inside of here. For all the resources that I'm mentioning, you're going to want to decide are you going to use EMR or handwritten SOAP notes. Handwritten SOAP notes are pretty easy right now. Just make the choices on what's the least amount of effort and friction to get the ball rolling and then come back and refine things and then go decide on which EMR system I'm going to use. Because if you're getting started, one of the worst things you can do is delay taking action and delay your success and delay seeing patience because you have all these choices to make. The most successful entrepreneurs make fast decisions and they don't always make right decisions. It's just about making a decision and moving forward. You can always change, you can always course correct. I think even Colin Powell used to say all we need is 40% of information to make a decision or as much as 70%. But we're never going to get more than 70% of the information. And he's making life or death critical decisions for the United States. So you don't need all the information, you just need some of it. Make a decision, move forward and move forward and then come back and course correct or refine. So you're also going to want in here is some kind of informed consent. This may be regulated by your state. In North Carolina for massage therapy, it's very regulated and they're very specific. For physical therapy it's in there, but it's not as specific, especially if you're going to be taking any like posture photos or emailing people or like actually touching them, which we are. We need their consent. We need some kind of consent. And this is can be in the same place as the payment policy and cancellation no show policy that I mentioned before. You want to have like a privacy statement and even a Medicare policy or beneficiary consent because if you're not a Medicare provider or even if you are a Medicare provider, you're going to have some kind of regulations as to how their consent is handled. Next section, marketing. Okay, how do we get this business off the ground? We've got to do some marketing, right? So we got to have a business and we've got to have a way to accept payment. But the marketing can kind of start while you're building these things. So it's going to be, it's really helpful to draw this out, map it out. That's why I've created the checklist in the first place. This kind of helps map this out in some of these steps. And you can check off. I got this, got this, got this. Some of these marketing pieces you need, some of them are nice to have like, like number one business logo. Do you need a business logo or a final business logo to do business? No. I know people who own multimillion dollar companies without a business logo. Think about that for a second. And without business cards. I'll give you a second to think about that. You don't need it. So what's absolutely critical? A logo and a fancy business name are not critical. Like I said before, you can always just go get Aaron LeBauer Rehab Services. Or you know, I might call it Greensboro Rehab Services or Specialist llc. Okay, Just some boring, lame title of a thing just to get a corporation, right? And then I can go create my DBA later on when I come up with a creative name or I can create a new corporation. No big deal. So don't let those things stall you out, okay? Do we need a logo? No, but you probably are going to want some kind of logo. And I can tell you what, I've got a few logos that were not professionally designed and they work just fine. And I've got some that were professionally designed and they work just fine, you know, so find something that you feel happy with and you feel good about and move forward with it. You will want a website blog. And your website should be more than a online brochure or business card. And if it's all about you, it's the wrong kind of website. There's a lot of other trainings I've done, even podcast episodes where we talk about what needs to go on your website. So go look for those. But your website should be about your patients and who you help and who you serve and how they can get in touch with you. And it should help you become easily found when someone Googles you online. When they Google you, you want a Google local listing. Okay? If you do not have one already, go search and claim it. If there's one that already exists. Let's say you've been in business for a little while or create a Google listing. And you can do this. If you're mobile or brick and mortar or work in a couple different places, you can have your mobile. It's going to be a service area listing. If you have a location, you're going to have a specific location listing. There's also an option for multiple locations. You need to claim it, you need to complete it, fill it out, put as much information and pictures and videos in there as possible. That way Google sees you as important. And start asking satisfied customers and patients or even former patients to write five star ratings and reviews on there. Business cards. Yeah, you could get business cards. I will say business cards is on the list, but I don't really give out business cards. People don't really ask for them. I will say, if I was going to update one thing, what would this be instead? It would be basically a printed version of my ebook or an information. It didn't even have to be an ebook. It can be an information card or a checklist. One of my mastermind students, Alexis Sams, has created an amazing like infographic, but it's really just a 1/3 column. It's like the 10 signs of core hidden core weakness or something like that. And it's something that can be easily given out, that provides tons of value. Right? Like a business card doesn't provide any value. It just says how to contact me, but something to hand out to people that has tons of value on one side or at the top and, and the bottom 10% tells them how to get in touch with me or how to claim a free total body diagnostic or talk to a pt. First call this phone number and on the back it might be an offer for my free ebook, you know, more value. So remember, when we're talking about marketing, you want to give, give, give, give, give. We also need you got a Google local listing. You're going to want to go online and set up a Yahoo and Bing Local listing and other search directories, Yelp, etc. One caveat about Yelp is set it up. But anytime they ask you to advertise, just say no, not right now. Don't say yes to advertising and don't say no. Just say no, not right now. Maybe later. And get your business and URL website listed everywhere. Even if you just have a little placeholder website right now and you've chosen your URL, just put it everywhere. To really start marketing, you're gonna want to build up a list of contacts. Okay? This is probably the most valuable thing that you will build as a business owner is your list of contacts. So this includes emails and phone numbers of people in your community. So patients, people that are interested, fitness professionals, yoga, Pilates instructors, personal trainers, people in your faith community, physicians, even people that you know. You need to build up a list of contacts and you're going to have kind of three different lists. You're going to have one that are customers or patients, right? You're going to have one that are prospects or prospective customers, clients or patients. And then you're going to have one that are people that have your customers. So physicians, yoga teachers, CrossFit, gym owners, who else? Personal trainers, the pastor, etc. Like can you offer them something of value for their community? So their community now sees you as the expert in health, wellness promotion, fixing injuries, back pain, etc. So you need to build your lists. Start brainstorming, specifically these people, because that's where you're going to start your marketing is with other people in your community to add value to them so that you can start getting them information about living a healthier, more physically capable life to share with their community. And your community sees you as an expert. And then nowadays people see you as the physical therapist, the answer to all their problems with their back pain or their herniated disc. And one of the things we're going to do then is we're going to take a lot of these contacts and lists. We're going to start sending out valuable emails to people. So email marketing, email marketing is huge. And a lot of people say email's dead or, you know, I don't want to send emails to people unsolicited. Well, they gave you their name, phone number, email for a reason, because they want you to help them. Or you send them one email and say, hey, I got your email from a friend. I'd love to know if you'd like me to help you learn more about X, Y and Z. If yes, click on the link here and go get my free book on back pain. If you want to see my video on the top five exercises to do to warm up for deadlifting, click here. And in that way you can segment and see what people want and get them on other lists and send them more information. And if they don't want to hear from you, you can say, hey, if you don't want to hear from me ever again, just click the unsubscribe button below. Okay? Email marketing is great. It's amazing. And if you haven't put together an email list of your current patients, you're not sending them information on a regular basis. You're missing out on tens of thousands, hundreds of thousands of dollars in revenue and thousands and even millions of people who you not impacting. Like you've got to start using email and maybe even text messages. Okay, so what's not in here? But I'm going to give you a special tip about marketing, that it's not in the cash P2 checklist, but that you're going to get for listening. This podcast is number one, you cannot fix a bad sales or conversions problem or customer service problem with more marketing. More marketing doesn't fix those things. So there's a couple different stages. There's prospects, so we're going to market the prospects and past customers. So marketing is about giving value. So there's brand marketing which is just saying, hey, we're great labour. Physical therapy is amazing. The physical therapy you deserve at the at the place that's best for you or whatever. Like, that doesn't say anything to people or there's direct response and relationship marketing. And direct response marketing is like that brochure I said, here's the 10 hidden signs of, you know, of back pain. Or the 10, you know, hidden signs of, you know, like, I don't know, core instability. And. Right. And at the bottom and say, here, do this. Just like, contact me today for a free total body diagnostic so that we can help you improve your back pain. Okay, great. I'm asking for people to do a. Give me a direct response. I'm asking them to call me or ask them to go to this website and download my free book. Go download the free. You know, maybe from the bottom of that is like, click here now and download your free video on what to do. If you've checked more than three of these, okay. And they go to that page, they enter their name, phone number, email, and they get my video that tells them what to start doing. That's direct response. That gets people into action. And once they start taking action, then they're ready to take more action. Become your patient or customer. Relationship marketing. Going out in the community and getting in front of people and giving them value and seeing them, building relationships, positioning other people as experts, giving other people shoutouts. Relationship marketing. Now, if on your back end, you're afraid to actually recommend a plan of care, you're hesitant to take money from people, especially more than $100, because where you've been working, it was only a $50 copay. Or you think, oh, $75 is enough, or no one would ever pay more than $100 or $150 or even 250, or that Aaron's special because they charge over $200 a visit, you've got to fix that problem. And that's a mindset problem. That's specifically a money mindset problem and a value problem. You have to fix that. Marketing won't change that. You fix it through mindset work, through books. Reading. You know, one of the books is you're a badass at making money. Okay, if you have a mindset problem, go read that. We also cover mindset that you need to be successful in cash practice. In my course, the Cash PT Blueprint, I have a whole mindset module because it's important. We talk about it a lot. We talk about sales and conversions in my course, my ethical influence course. And there's a lot about mindset. Almost half that course is just convincing people who are attending the course that you're worth what you're charging and and what you're delivering to people and fixing mindsets so that we can sell. Because if you believe physical therapy is what people need, it's your absolute ethical obligation to learn how to sell physical therapy. Make sense if you believe that people need physical therapy and not an injection and not a surgical intervention for non specific low back pain and physical therapy is the answer. Physical therapy is the answer to the Medicare problem, to the PDPM issue. Physical therapy is a solution to the opioid epidemic, then it's your ethical obligation as a physical therapist to learn how to sell physical therapy to the public. Get it? Great. Okay, so what's next? Well, number one, go get your cash PT checklist. Go to cash pdchecklist.com what I'll do is as soon as you go there and enter your name, phone or email, I'll send you a hard copy of the Cash PD checklist with links to all the resources I mentioned in this episode. And then number two, you'll get an invitation to join me on my next webinar so that you can learn how to launch and grow your physical therapy practice. And what you're going to learn on that webinar, it's free. Remember you're going to get the step by step template to start experimenting. Cash Practice from scratch. You learn how to seamlessly transition your in network practice to 100% cash based. Just like one of my mastermind members, Marcy. You'll get easily get patients to contact you directly to schedule an evaluation. So you're going to learn how to do that and you're going to learn how to have freedom in practice so that you can treat patients the way you want, not the way insurance dictates or you've been pressured into billing units or the boss or the PT mill wants you to do it. You treat patients as you decide they should be treated, not insurance companies because remember we work for patients, not insurance companies. You're going to learn how to be able to set your own schedule, spend more time with your family, generate enough revenue to pay down your loans so you can finally take that vacation and have the life of your dreams that was promised to you so that you can enjoy the world and make a huge impact on it at the same time. So in order to get access to that training, go to cash pdchecklist.com you'll get the checklist and then in one of my follow up emails you get a link to get on the webinar and I'LL see you on that webinar. I'll see you on the next podcast episode where I'm going to talk about the 35 marketing strategies, my top 35 marketing strategies to drive traffic to your clinic's website and generate new patients without relying on referrals from physicians or buying expensive ads. See you on the next show.